We offer different treatment options for the contracture of your hand
Surgery is not needed if the finger can be straightened fully. Intervention is generally recommended when the patient develops contractures of the finger joints of greater than 30 degrees and when it has become impossible to put the hand flat on the table.
Over the longer term, Dupuytren's contracture may reappear in the operated fingers or in previously uninvolved areas of the hand, although most patients who require surgery need only one operation during their lifetime. There are two types of surgery for Dupuytren’s contractures and the choice between these two depends on the severity of your symptoms and pre-existing health conditions. Your surgeon will advise on the best type of surgery needed for your finger contracture.
Percutaneous Dupuytren’s needle fasciotomy
Needle fasciotomy is a particularly useful technique in patients who only have a contracture in the palm affecting the metacarpo-phalangeal (knuckle) joint. These contractures are caused by a prominent cord of tissue that arises in the palm and extends to the base of the finger. The finger can be straightened by dividing the cord of tissue using a small hypodermic needle. The diseased tissue is not removed. It is performed using local anaesthetic and may be useful for patients who might not tolerate anaesthesia so well. The main advantages of this technique include the small wound and a quick recovery. There is a higher risk of recurrence of the contracture when compared to a fasciectomy (open surgery).
Open Dupuytren’s fasciectomy (release)
The procedure may be carried out under local, regional (injection of local anaesthetic at the neck or arm) or general anaesthetic.
The traditional operation for Dupuytren's contracture is known as a fasciectomy. The aim is to remove that part of the fascia in the palm and fingers that is causing the contracture. Although the deformity improves, there is still a risk of recurrence. Nevertheless, it is still probably the "gold standard" and most widely used treatment, especially for proximal interphalangeal joint contractures.
In specific cases (recurrent disease, an aggressive disease in younger patients) there may be an indication for a dermofasciectomy, which combines the removal of the diseased fascia with the removal of part of the overlying skin of the finger, which is then replaced with a skin graft taken from the forearm.
- Percutaneous Dupuytren’s needle fasciotomy
- Open Dupuytren’s fasciectomy (Release)